Willow ABA Services LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

WILLOW ABA SERVICES LLC

Practice address

2815 Exchange Blvd Ste 100
Southlake, TX 76092-7515

Phone

(913) 375-3626

NPI assigned

Mar 3, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tanner Sierks

Title

Owner

Phone

(913) 375-3626

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1583193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583193600000",
    "number": "1639704372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7150 CAMPUS DR STE 290",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809206508",
            "telephone_number": "913-375-3626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2815 EXCHANGE BLVD STE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760927515",
            "telephone_number": "913-375-3626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW ABA SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-03",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A",
        "authorized_official_last_name": "SIERKS",
        "authorized_official_first_name": "TANNER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "913-375-3626"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@willowaba.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "address_1": "2815 Exchange Blvd Ste 100",
            "city": "Southlake",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760927515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mary Lindsey Williams, APRN
• Meghan Williams, BCBA, MA
• Stuart F Williams, DO
• Sydnee Nicole Jordan Williams
• Brad Williamson
• Tayla Wilshire, BCBA
• Dana Wilson
• David Wilson, MD
• Jessica L Wilson, R.PSGT
• Mary Wilson, RD

• Behavior Analyst in Southlake, TX
• Providers in Southlake, TX by specialty
• Behavior Analyst in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.